改良早期预警评分在院前急救老年患者病情评估中的应用

Application of the modified early warning scoring to the assessment of conditions of elderly patients in prehospital first aid

目的：探讨改良早期预警评分（MEWS）在院前急救老年患者病情评估中的应用效果。方法：对我院2011年院前急救的281例60岁以上老年患者的病历资料进行回顾性调查，分析MEWS与患者去向和预后的相关性及临床应用意义。结果：MEWS0—3分者病死率为4．15％，4～8分者病死率为8．82％，〉9分者病死率为100．00％。MEWS以死亡为预测指标的ROC曲线下面积为0．902，表示MEWS对院前急救老年患者死亡风险的预测有较高的准确性。结论：MEWS分值越高者死亡风险越大。MEWS适用于对院前急救老年患者快速评估病情，以便采取相应治疗和护理措施。

Objective ： To investigate the effect of the modified early warning scoring （MEWS） in the assessment of conditions of elderly patients in prehospital first aid. Methods：The medical records of 281 elderly patients （over 60 years old） who received prehospital first aid in 2011 were retrospectively studied and the correlation between MEWS and the patientsprognosis and the significance of its clinical appli- cation was analyzed. Results：The fatality rate was 4.15% when MEWS was 0 to 3 points,the fatality rate was 8.82% when MEWS was 4 to 8 points and the fatality rate was 100% when MEWS was more than 9 points. The area under ROC curve taken as the prediction index of death was 0.902 ,indicating that the prediction of MEWS in mortality risk of elderly patients with prehospital first aid was accurate. Con- clusion ： The higher the value of MEWS is, the greater the risk of death is. MEWS is suitable for the rapid assessment of conditions of elder- ly patients with prehospital first aid, so the corresponding treatment and nursing measures can be taken in time.